PDF(Sci-hub)
Abstract：
Objectives Short interpregnancy intervals (IPI) have been linked to multiple adverse maternal and neonatal outcomes, but less is known about prolonged IPI, including its relationship with labor progression. The objective of the study was to investigate whether prolonged IPIs are associated with longer second stages of labor. Methods A perinatal database from Kaiser Permanente Hawaii was used to identify 442 women with a prolonged IPI ≥60 months. Four hundred forty two nulliparous and 442 multiparous women with an IPI 18-59 months were selected as comparison groups. The primary outcome was second stage of labor duration. Perinatal outcomes were compared between these groups. Results The median (IQR) second stage of labor duration was 76 (38-141) min in nulliparous women, 15 (9-28) min in multiparous women, and 18 (10-38) min in women with a prolonged IPI (p<0.0001). Pairwise comparisons revealed significantly different second stage duration in the nulliparous group compared to both the multiparous and prolonged IPI groups, but no difference between the multiparous and prolonged IPI groups. There was a significant association with the length of the IPI; median duration 30 (12-61) min for IPI ≥120 months vs. 15 (9-27) min for IPI 18-59 months and 16 (9-31) min for IPI 60-119 months (p=0.0014). Conclusions The second stage of labor did not differ in women with a prolonged IPI compared to normal multiparous women. Women with an IPI ≥120 months had a significantly longer second stage vs. those with a shorter IPI. These findings provide a better understanding of labor progression in pregnancies with a prolonged IPI.
摘要：
目的短的妊娠间隔（IPI）与多种不良母婴结局有关，但对延长IPI的了解较少，包括它与劳动进程的关系。该研究的目的是调查延长的IPI是否与更长的第二产程相关。方法使用夏威夷KaiserPermanente的围产期数据库来鉴定442名IPI延长≥60个月的妇女。选择42名IPI为18-59个月的未产妇女和442名多产妇女作为对照组。主要结局是第二产程。比较两组围产期结局。结果未分娩妇女第二产程中位数(IQR)为76(38～141)min,15（9-28）分钟在多胎妇女，和18（10-38）分钟的女性IPI延长（p<0.0001）。成对比较显示，与经产和延长的IPI组相比，未产组的第二阶段持续时间显着不同。但经产和延长IPI组之间没有差异。与IPI的长度存在显着关联；IPI≥120个月的中位持续时间为30（12-61）minIPI18-59个月为15（9-27）分钟，IPI60-119个月为16（9-31）分钟（p=0.0014）。结论与正常经产妇女相比，IPI延长的妇女的第二产程没有差异。IPI≥120个月的女性第二阶段明显更长。IPI较短的人。这些发现为IPI延长的妊娠提供了更好的理解。
